Antecedents and consequences of workplace serostatus disclosure among a diverse, urban sample of employed HIV-infected people

Employment is an increasingly important domain of life for HIV-infected persons. The workplace is emerging as a more common context for HIV disclosure. This investigation examined some of the individual and organizational antecedents and consequences of workplace serostatus disclosure.; Among the ethnically and occupationally diverse sample of 156 employed individuals with HIV/AIDS, more than half (52.9%) had disclosed their viral infection at work. The majority of respondents worked for small employers, and were either gay or bisexual men.; Coworker social support emerged as the strongest predictor of disclosure. Those who did disclose also tended to be slightly more adherent to their medial regimens, while at work. However, experiences of discrimination appeared to negatively affect adherence. Unexpectedly, less than 20% of the respondents in this sample were cognizant of their employer having a specific organizational HIV/AIDS policy.; Inhibition theory predicts that the act of disclosure of trauma reduces the experience of certain psychosomatic illnesses. There were only small differences in perceived mental and physical health detected between disclosers and non-disclosers, and no differences in average monthly CD4 cell count or viral load. In contradiction to hypotheses, disclosers were in poorer subjective health.; Environmental responses to individual's needs also influence health and behavioral outcomes. As hypothesized, disclosers' experiences of workplace stigmatization, particularly feelings of financial insecurity, had strong effects on workplace behavioral intentions. Lack of support from the immediate supervisor was found to influence the HIV-infected worker's intention to take legal action against an employer and/or leave the organization. The data also suggest that instrumental support resources may have been used as a coping mechanism for those who chose not to disclose, allowing them to discretely manage their illness and maintain health.; This investigation found that inhibition theory was not an appropriate model for explaining the many and varied consequences of workplace disclosure, but that theories of stigma and social support should be utilized in future attempts to understand this process. The social climate, as enacted by coworkers and supervisors, was found to be a critical determinant of the decision to disclose and of the consequences of disclosure. The implication for organizational leaders is for the development and/or implementation of more effective training of employees, particularly supervisory personnel, on HIV/AIDS, the proper treatment of seropositive employees, and the management of employee reactions to disclosure. The suggestion of a relationship between organizational programs and health, points to the importance of crafting suitable human resource policy and programs that facilitate the HIV-infected individual's management of his or her illness and work life.